University of Washington (UW) School of Nursing (SoN), Seattle: Educational Programs, 2012
and beyond Appendix M
Internal Talking Points (12/12/11) and background for UW use regarding proposed transitioning to the Doctor of Nursing
Practice (DNP) as the primary entry point for advanced practice at the Seattle Campus. This document is for preparation
purposes only and not for circulation. An external message is available from Phillippa Kassover, senior director for
advancement, for circulation. The Seattle Campus Fact Sheet is linked here.
This document describes the key recommendation and rationale, timing, degree programs offered and Tri-Campus
collaboration, impact to students, communication plan, local and national nursing programs, points of information, and
background/benefits of this transition.
Key Recommendation and Rationale: The faculty of the School of Nursing (SoN), Seattle, met in late November 2011 to
discuss offering the Doctor of Nursing Practice (DNP) as the primary entry point for advanced practice. After much
deliberation, the faculty voted to recommend this change, effective academic Year 2012-2013. Planning is now underway
to fully evaluate this proposed transition to DNP to prepare advanced practice registered nurses (APRNs) at the UW SoN.
Admissions to the Master of Nursing (MN) specialties (see table at the back) will be paused for the 2012-2013 academic
year until final decisions are made utilizing University resources for “Reorganization, Consolidation, and Elimination
Procedures” (RCEP), a set of procedures outlined in the Faculty Code, Chapter 26, Section 26-41.
The DNP was established at the SoN, Seattle, in 2005. The first cohort was post master’s APRNs; the first post-baccalaureate
cohort was admitted in 2007. This move would complete the transition from Master of Nursing (MN) entry into Advanced
Practice Registered Nurse roles to DNP entry, and would align with escalating national demand to prepare APRNs to assume
leadership and educator roles in academia and practice settings. Given compelling health care needs of the state and the
nation, the timing for this change is critical.
The SoN Strategy Map, adopted in August 2011, set strategic imperatives to Advance Research, Education and Practice;
Achieve Operational Excellence; Create a Secure Financial Future; and Build a Sustainable Organization. This proposed
transition is consistent with longstanding and current strategies of the School, national trends in nursing education,
changing needs in the profession, and nursing workforce issues. This transition would also serve the School’s goals to
develop a sustainable, transparent and effective financial model focused on the need to reduce program offerings and
increase efficiency, and align fiscal resources with academic programs. Additionally, the SoN would be able to reduce
program costs, streamline curricular offerings, capitalize on faculty strengths and continue to provide leadership for the
state and nation.
Timing: The timing of this recommendation was made after careful consideration for the students. Any changes to
offerings needed to be made prior to application review and offers of admission for 2012.
Degree Programs: Even after the proposed changes, SoN Seattle will continue to offer six degrees:
• Bachelor of Science in Nursing (BSN)
• Accelerated Bachelor of Science in Nursing (ABSN)
• Masters of Science in Nursing (MS)
• Masters of Nursing (MN)
• Doctor of Philosophy in Nursing Science (PhD)
• Doctor of Nursing Practice (DNP)
Tri-Campus Commitment: The three campuses of the UW SoN – Bothell, Tacoma, and Seattle – will continue to collaborate
in maintaining the Master of Nursing degree. Furthermore, the SoN supports the need to expand student access as needed
to the Master’s level degree at UW Bothell and UW Tacoma campuses. UW’s tri-campus commitment leverages the
complementary strengths of each campus, resulting in expansion of commitment to the continuum of future nursing
educational needs, from Bachelor’s through Master’s and Doctoral levels.
Impact on UW-Seattle Students:
• All currently enrolled MN students in advanced practice specialties are able to complete their degrees intact with
strong faculty support for their individual and collective needs.
• MN and DNP entry to Community Health Nursing (CHN) will not be affected, as CHN is not an Advanced Practice
Registered Nurse role as defined by the APRN Consensus Model. The Master of Science – Clinical Informatics and
Patient Centered Technologies (CIPCT) option is not affected for the same reason.
• All clinical specialties are expected to continue, however, discussions are being held about further streamlining of
the curriculum, including creating a more robust core curriculum. This new approach will consider fewer offerings
with larger enrollments, a focus on interprofessional education, improved student advising, and increased
consistency among specialty offerings. Reduced costs are expected for administrative support due to improved
processes and fewer offerings.
• The Master’s—in—Passing (MIP) option is available for students who choose this option while in the Doctor of
Nursing Practice (DNP) program. They receive a Master’s of Nursing degree. The MIP allows students to complete
their advanced practice certification exam in their specialty and obtain a Washington license as an APRN while
finishing the DNP. Since 2007, 36 DNP students have received MIPs, 16 of whom eventually graduated with the
DNP and 14 of whom are currently finishing their DNP. To date, 3 students have exited with the MIP and 3 are on
• Additional scholarship money will be identified to meet unmet need.
• The following message was sent to Faculty, Staff and Students and has also been posted on the SoN web site in
several places for prospective students:
o The SoN is considering temporarily pausing admissions to MN advanced practice nursing specialties for the
2012-13 academic year. If this occurs, all affected applicants will be personally contacted and advised of
alternative program options. A pause would have no effect on currently enrolled students, who would be
able to complete their current programs in MN specialties. No changes are envisioned for the Master of
Nursing – Community Health, or the Master of Science – Clinical Information and Patient Centered
Technologies (CIPCT). All faculty, staff, and students will be informed as soon as a final decision has been
• Application fees paid by prospective students with current-in-process applications to the affected Master of Nursing
specialties will be refunded or transferred to the DNP application.
• The faculty voted to pause admission to MN entry into Advanced Practice specialties (Nurse Practitioner, Clinical
Nurse Specialist, Nurse Midwifery) for 2012-13 while a cost/benefit and impact analysis is conducted. These
analyses are planned for completion in early Winter 2012, led by the Shared Leadership Council (faculty council
and department/unit leadership). (see Table on page 7)
• Analyses will be used to develop recommendations for faculty consideration. Faculty will vote on RCEP. This will
likely be done in Winter 2012 as well.
• The Master’s—in—Passing is and will continue to be available to DNP students.
• Provost and SCPB will receive the RCEP request and make their determinations.
• Formal announcement of the decisions would be made to the School and prospective students soon thereafter.
Local and National Nursing Programs:
• Washington State University and Seattle University are launching DNP programs in 2012. The UW SoN shared
proposals, and information about funded grants and programs experience to assist WSU to begin its program.
• In response to national and professional initiatives to make the DNP the standard academic preparation for
advanced practice registered nursing education by 2015, 260 Schools of Nursing (AACN website) now offer or are
poised to offer the DNP.
• National enrollment in the DNP programs has increased exponentially from 170 students in 2004 to 7,037 in 2010.
From 2007 through 2011, 221 SoN students matriculated into DNP advanced practice specialties. With the change
to DNP-only for advanced practice, we expect to admit 70 students in academic year 2012-2013.
• The Peer Deans who visited UW SoN in November 2011 from University of Pittsburgh, Indiana University and the
Medical College of South Carolina recommended UW Seattle offer only the DNP for entry into advanced practice.
• As a point of interest, a current UW DNP student recently interviewed with University of Wisconsin, Madison for a
job. The student’s DNP preparation was enthusiastically recognized. A 2010 post baccalaureate DNP graduate
reported being hired by a health care organization in Seattle primarily because she had the DNP. She reported that
without the DNP she would not have been called to interview.
• SoN tuition rates are comparable to our peers including Johns Hopkins, Michigan and University of Illinois.
Points of Information:
• The University of Washington SoN began offering the DNP initially to post MN APRNs, graduating the first cohort in
2008. The post baccalaureate DNP degree option began in 2007. Since that time, several important program and
policy changes have occurred, making it challenging to use historical application data to forecast future
applications. The net result is that DNP application trend data cannot be considered in isolation or as a predictor
for the future.
• The UW DNP offerings are unique in the Washington, Wyoming, Alaska, Montana, Idaho (WWAMI) region. Those
only offered by UW at the DNP level in the WWAMI region are Adult Clinical Nurse Specialist (ACNS); Adult Nurse
Practitioner (ANS): Pediatric Nurse Practitioner (PNP); Neonatal Nurse Practitioner (NNP); Perinatal Nurse Specialist
(PNS); Neonatal Clinical Nurse Specialist (NCNS); and Psychiatric Mental Health Nurse Practitioner (PMHNP).
• The Psych-Mental Health NP, Family Nurse Practitioner, Adult Nurse Practitioner, and Community Health Programs
have been ranked one, two or three in US News & World Report.
• Looking only to academic year 2011-2012 data, approximately 50% of both MN and DNP applicants were offered
admission to their respective specialty programs, reflecting relative strength in applicant pool sizes. SoN Academic
Services staff estimate that approximately 75% of those who might formerly have applied to the MN program will
convert to DNP applicants. Under this assumption, applicant pool size would likely continue to exceed expanded
DNP enrollment capacity. The net reduction in total overall applications with the shift to DNP advance practice
entry may yield application review savings of approximately $12,400.
• Tuition rates for the MN and the DNP are identical on a per quarter basis. Some programs are fee based (charge by
credit hour) and some are state supported (with resident/non-resident differential), but either way rates are
• The costs of clinical courses vary among specialties, with the variation coming from the type of clinical courses that
are needed (scattered vs. central locations and the way that each department conducts their clinical courses—
Faculty Clinical Advisor (FCA) or no FCA. Using the Adult Nurse Practitioner (ANP) offerings as an illustration, the
overall cost per credit hour for the combined ANP offerings is $238, clinical course costs are $412/student credit
hour and independent study courses are $524/student credit hour. Faculty members are currently working on
curriculum alterations to encourage more cost effective choices by students.
• This move to DNP only for advanced practice preparation is expected to save administrative time and cost for staff
and faculty due to fewer offerings, increased streamlining and standardization, and curriculum consolidation.
• By pausing admission to advanced practice specialties at the Master’s level for the academic year 2012-13,
educational offerings will be reduced by 45%. After careful analysis and decision making, we expect offerings to be
sent through the RCEP (Reorganization, Consolidation, and Elimination Procedures) process. Ultimately, this
related reduction in program complexity is expected to result in cost savings. For example, faculty time will be
reduced by no longer having to supervise MN projects, although they will supervise DNP Capstones. We have
baseline costs now and will monitor and report cost reduction by specialty and in aggregate.
• UW DNP graduates (73 to date) are able to secure jobs and secure them at a higher rate of pay than MN graduates.
SoN graduates are most frequently hired at UWMC, Veterans Administration, Group Health Cooperative, Pacific
Medical Center, Virginia Mason, Seattle Cancer Care Alliance, Children’s Hospital and Medical Center, Overlake
Medical Center (Bellevue), Northwest Hospital, St. Peters Hospital (Olympia), Valley Medical Center, Evergreen
Medical Center (Kirkland), Harborview Medical Center, Sea Mar Primary Care Clinic, and Providence Everett Clinic.
• Nationally, salaries for DNP graduates are higher than for MN graduates. Based on 3 – 5 years of experience, DNPs
make an average of $96,572 and MN’s make an average of $88,444. Source: National Salary and Workplace Survey
of Nurse Practitioners. See next section for benefits to health care.
Background and Benefits of this Move:
To Meet Health Care Needs in Washington:
• Since 2006, UW DNP training programs have been awarded approximately $3 million in federal funding to develop
and support the education of DNP students, including stipends and tuition support for some. Our data show that
87% of our DNP alumni stay in Washington to practice and serve patients, families and communities, representing a
significant federal investment in the Doctoral-level Advanced Practice nursing care for older adults and families in
• Every DNP student is required to complete a Capstone Project. Capstone projects are systematic investigations of
questions about practice and therapies that evaluate and translate evidence into practice. Each student
collaborates with an agency to solve a real-world clinical problem. Agencies benefit by having students with cutting
edge education lead and manage difficult projects at no cost to these agencies. A list of capstone projects can be
found here: http://nursing.uw.edu/academic-services/degree-programs/dnp/past-capstone-projects.html
• The Veterans Administration Center of Excellence in Primary Care is committed to educating DNP students at the
Seattle site as future leaders in interprofessional collaboration and in the complex care needed by our veterans.
SoN is helping to lead this work.
• The UW DNP program recruits students from rural areas and the programs emphasize working with underserved
citizens in urban and rural areas. List of programs: http://nursing.uw.edu/academic-services/degree-
• The UW DNP for community health nurses prepares nurse leaders to assure that essential Washington public health
services are provided with efficient and effective leadership, research-based decision making, and rigorous
evaluations for continuous quality improvement in community health programs.
• Governor Gregoire’s 2011 Healthiest State agenda calls for stopping “out of control cost increases in health care by
redesigning the system and creating a more valuable and productive health sector.” A key DNP program goal, to
prepare excellent practitioners who can “create, manage, and evaluate innovative programs and practices of care
for diverse populations,” carefully aligns with the state’s goal. Source: US Human Resources and Services
Administration (HRSA). Advanced Practice Education # 71791. : Collaborative Mental Health. E. Walsh, PI, F.W.
O’Connor & K.G. Schepp, CO-PI. Funded 2011-2014.
• The DNP program prepares nurse practitioners to address the increasing complexity of patient needs, including
chronic illnesses, and health management challenges associated with our rapidly aging population.
To Meet Health Care Needs Nationally:
• The National Academies recommended in 2005 that Nursing develop a non-research clinical doctorate (DNP),
similar to the MD, PharmD, and Physical Therapy to fill the need for clinical practice and for clinical education. They
recommended that the PhD in Nursing be the focus of those who wished to pursue a research career that adds to
the body of knowledge of nursing science. DNP-prepared faculty members meet a valuable need to educate the
future nursing workforce.
o The UW is a leader in producing faculty for nursing practice instruction.
o Currently five UW faculty members hold the DNP degree and provide core content and practice mentorship
to current students. See the “Student and Faculty Experience (Stories)” section below for specifics.
• Recent transformation of health care to evidence-based practice requires the expertise emphasized in the DNP
program for appraisal and translation of current research and other evidence to guide decision making on a macro
and micro level for cost effective, quality care.
• DNP education includes understanding organizational culture, analysis of initiatives, and budget development (all
critical in our current and future health care environment).
• Nationally, there is consensus on the existence of a current and future nursing faculty shortage. UW Seattle
prepares future leaders in education, research and practice.
o The average age of a doctorally prepared nurse faculty is 60.5 (professors) and 57.1 (associate professors)
years. American Association of Colleges of Nursing (AACN) reports the current vacancy rate in nursing
faculty is 7.7% and expects this to rise significantly in the coming decade
o A 2010 AACN survey found that 56% of nursing school survey respondents reported faculty positions left
To Best Prepare Practitioners (students):
• Prepares students to meet the increasing complexity of the health care system.
• Focuses on Evidence-Based Practice and its implementation in care settings to facilitate rapid translation of new
knowledge into practice standards.
• Integrates practice with higher-level content on care systems, leadership, team-building, and evidence appraisal
that will result in improved quality care and patient safety.
• Positions Nurse Practitioners to lead and collaborate in shaping responses to new health care policy and
• Prepares Nurse Practitioners needed as a result of health care reform and emphasis on an integrated generalist
approach to primary care
To Advance Leadership in the Profession:
• AACN advocates that having one path to APRN practice will provide clarity to students, employers, and the public.
Nursing specialists will be prepared at the highest level in educational programs on par with those who educate
professionals from other health disciplines. As a recognized leader in nursing education and research, the UW SoN
is expected to establish and is committed to the highest standards of DNP education and preparation and to
disseminating these standards nation-wide.
• The UW SoN led the state and region in the development of the DNP program. The UW DNP program educates an
advanced practice clinician who has the knowledge and skills to integrate advanced clinical practice, leadership, and
• The UW DNP program prepares graduates to achieve credentialing and licensure in their chosen field.
• Some Nursing professionals and educators are opposed to the DNP for advanced practice. The primary reason is
the additional time needed for completion of the program, which in turn increases costs for students. Despite this
same consideration for nearly all health professions, within the past few years the Physician Assistant’s program at
UW has transitioned from a bachelor to a master degree, and the physical therapy, occupational therapy,
audiology, and pharmacy fields have transitioned to a professional doctorate. The main motivation for the longer
period of study is the explosion of knowledge and the additional skills required to meet the increasingly complex
needs of our state's residents for health care that is also safe, appropriate, and effective. The aging of the
population, the increasing ethnic diversity of the state and nation, and the escalating incidence of multiple chronic
illnesses have been associated with the need to prepare health professionals who can manage complexity.
• Several (older) studies also document that nurse practitioners prepared with a master degree are effective and
comparable to physicians in delivery of primary care. As more recent changes in the complexity of practice can be
traced to the last two decades, we have learned that our students need more preparation in advanced practice,
practice inquiry and leadership in order to deliver optimal care.
Student and Faculty Experience (Stories):
• Capstone Project: As part of the Immunization Action Coalition, and in partnership with Group Health Cooperative,
the organization called “Within Reach” aims to increase the level of immunizations for children in Washington
State. The first DNP student involved with this project developed a toolkit to assist pediatric providers working with
vaccine hesitant parents. A second DNP student created an innovative resource guide for Obstetric providers at
Group Health Cooperative regarding newborn Hepatitis B vaccination. The third student is following up on the
feasibility of and implementation of the Hepatitis B program. In all instances, students have translated the current
evidence to practice changes for improved patient outcomes. Students also present and publish their findings.
• Capstone Project: At the request of Group Health Cooperative, a DNP student worked with the NPs to develop and
implement a new NP led approach for patients with irritable bowel syndrome based on years of research by UW
faculty. The program is currently underway and another DNP student is now leading phase 2 of the project to
evaluate this exciting approach to improving practice
• Video from students describing their experience as well as information about the DNP program can be found at:
• UW DNP faculty:
• Clinical Assistant Professor, Christine Hoyle DNP, ARNP, FNP, whose work has been with underserved,
ethnically diverse patient populations in primary care public health settings in Washington State. Precepts
DNP students in her clinical practice.
• Clinical Assistant Professor, Gail Johnson DNP, ARNP, FNP, whose work has also been with underserved,
ethnically diverse patient populations in community health clinic settings in Washington State. Precepts
DNP students in her clinical practice.
• Clinical Instructor Teresa Garrett-Hill DNP, MN, who has worked in tribal health in Washington State and
uses these experiences with undergraduate students studying community health.
• Clinical Assistant Professor, Karen E. Hays, DNP, CNM, ARNP is a certified nurse-midwife who has worked in
community hospitals, home birth, birth centers, and a tertiary hospital. She has also served as a consultant,
educator, and practitioner in several countries across Asia, Africa, and Latin America.
• Lecturer Kumhee Ro, DNP, ARNP, FNP-BC whose work with people who are underserved, ethnically diverse
and homeless in her current NP practice in the emergency department offers extensive expertise for
teaching adult/geriatric and family NP students.
• Washington State University has also hired a UW DNP Graduate:
• Clinical Assistant Professor, Dawn Rondeau, ACNP, FNP, DNP has been a critical care nurse and inpatient
department director with 125 employees and a $12 million dollar budget. Similar to her counterparts at
UW, her teaching responsibilities include advanced pathophysiology, pharmacology, physical assessment,
For more information, please contact: Phillippa Kassover (firstname.lastname@example.org) or Ruth Johnston (email@example.com)
School of Nursing Graduate Current Program Offerings/Status 12/12/11
Master of Nursing
Tuition base Tuition base Pause
WA* Adult Clinical Nurse Specialist (ACNS) yes
Adult Nurse Practitioner (ANP) – includes yes
Adult Care NP
Neonatal Nurse Practitioner (NNP) yes
EO Perinatal Nurse Specialist (PNS)
Neonatal Clinical Nurse Specialist (NCNS)
EO Nurse Midwifery (NM) yes
WA Pediatric Nurse Practitioner (PNP) and yes
Pediatric Clinical Nurse Specialist (PCNS)
WA Community Health Nursing no
WA Psychiatric Mental Health Nurse Practitioner yes
WA Independent Master of Nursing yes
Master of Science
Clinical Info & Patient Centered Technologies no
WA Independent option, Master of Science yes
Doctor of Nursing
WA Adult Clinical Nurse Specialist (ACNS) no
Adult Nurse Practitioner no
EO Family Nurse Practitioner (FNP) no
WA Pediatric Nurse Practitioner (PNP) no
Neonatal Nurse Practitioner (NNP) no
EO Perinatal Nurse Specialist (PNS)
Neonatal Clinical Nurse Specialist (NCNS)
EO Nurse Midwifery (NM) no
WA Community Health Nursing (CHN) no
WA Psychiatric Mental Health Nurse Practitioner no
Post Master’s not seeking a new specialty no
Doctor of Philosophy
in Nursing Science
WA PhD in Nursing Science no
WA=state supported EO= Fee-based
DRAFT DNP Decision statement for external use (we expect this will be edited as needed)
In response to declining state support and in line with earlier aspirational decisions, the University of Washington School of Nursing
faculty voted on November 28, 2011 to propose that as of Summer Quarter, 2012 the Doctor of Nursing Program will be the only
program to prepare advanced practice registered nurses (nurse practitioners, clinical nurse specialists and nurse midwives) at the
University of Washington School of Nursing, Seattle.
The School will take the following steps immediately:
• Pause admission to the Masters level advanced practice specialties for 2012 – 2012
• Faculty members will individually contact Masters applicants to offer them the opportunity to apply to the UW DNP programs
• Continue to allow students to exit with a Master’s degree with a certification in a specialty prior to completion of the DNP
program, so students can choose to participate in the workforce as advanced practice nurses and complete their professional
• Allow all current Masters students to complete their program
The Master’s degree in Community Health and the Master of Science in Clinical Informatics and Patient-Centered Technologies will
continue and are not affected by this decision. The University of Washington will also continue its Bachelor’s and Accelerated Bachelor’s
in Nursing and PhD in Nursing Science programs.
The decision was made at this time to enable current applicants to UW Masters advanced nursing practice programs to make decisions
about their course of education. Applications for the masters programs are now closed. Applications for Doctor of Nursing Practice
Programs close on January 15, 2012.
Faculty determined that this important step was needed as part of their work on a comprehensive sustainable academic business plan.
Faculty wished to provide an overall direction for advanced practice education at the UW School of Nursing and will continue the
process of review and prioritization of the range of advanced practice specialties currently taught at the school.
The faculty recommendation was based on their assessment of the direction of the profession and the unique strengths in leadership,
practice and research at the UW School of Nursing. The history of advanced practice nursing education started with a four-month
certificate, which evolved to a two-year Master’s degree and now includes a three-year professional Doctorate in Nursing Practice.
Many UW School of Nursing alumni with early advanced practice degrees have been pioneers in advanced practice and have paved the
way for this evolution toward the professional doctorate in advanced practice nursing.
The University of Washington School of Nursing has long been committed to preparing advanced practice nurses who utilize evidence-
based practice, are equipped to become leaders in health care systems and are primed to educate future advanced practice nurses.
Health care reform and the increasing pressure on all health care systems will require advanced practice nurse leaders to participate in
redesigning health systems that focus on the life span. Advanced practice nurses are also well prepared to lead interprofessional health
care teams that provide coordinated, patient-centered care and offer primary care to patients and their families.
The American Association of Colleges of Nursing (AACN) has set a 2015 target goal for transition of all advanced practice registered
nurse education programs. The Association’s position is that the DNP is the appropriate degree for advanced nursing practice.
About the School of Nursing
The University of Washington School of Nursing’s mission is to advance nursing science and practice through generating knowledge and
preparing future leaders to address local, national and global societal needs. This work is informed by a set of foundational values:
collaboration, social responsibility, integrity, respect, accountability, diversity and excellence.